SAS®
Detection and Investigation for Insurance

SAS® Detection and Investigation for Insurance

Detect, prevent and manage claims fraud across all lines of business.

You don't have to accept claims fraud as a cost of doing business. SAS® Detection and Investigation for Insurance provides an end-to-end solution for detecting, preventing and managing both opportunistic and organized claims fraud across multiple lines of business, with components for fraud detection, alert management and case handling.

Get a consolidated view of fraud risk.

Identify linkages among seemingly unrelated claims, and identify cross-product fraud. A unique visualization interface lets you see customer claims and policies for all lines of business, and analyze all related activities and relationships at a network dimension. Social network diagrams and sophisticated data mining capabilities give you a better understanding of new fraud threats, enabling you to prevent substantial losses early. And you can stay on top of changing claims fraud trends by continually improving models and adapting the system.

A sophisticated fraud scoring engine enables you to identify claims fraud with greater speed and accuracy. By quickly determining which claims require further scrutiny and which ones don't, you can significantly reduce false positives – which means a better customer experience. Automatic scoring lets you prioritize higher-value claims, entities and networks, while advanced case handling tools enable more efficient, effective investigations – and a higher ROI per investigator. In addition, all claims settlement amounts are captured within the system for reuse with similar claims in the future.

Advanced analytics with embedded AI. Provides a broad set of advanced analytic and AI techniques, including modern statistical, machine learning, deep learning and text analytics algorithms – accessible from a single environment.

Detection and alert generation. Calculates the propensity for claims fraud at first submission with a scoring engine that combines business rules, anomaly detection and advanced analytics; then rescores claims at each processing stage as new claims data is captured.

Alert management. Combines alerts from multiple monitoring systems and associates them with common individuals for a more complete view of risk for individuals or groups.

Social network analysis. Provides a unique visualization interface that lets you go beyond transaction and detailed claims views to analyze all related activities and relationships at a network dimension.

Search and discovery. Lets you perform free-text, field-based or geospatial searches across all internal and external data, and refine searches using interactive filters.

Case handling. Streamlines operations with a configurable workflow that provides a systematic means of conducting investigations, and captures and displays all information pertinent to a case.

Flexible deployment options. Enables you to choose the deployment option that works best for you – complete hosting by SAS, deployment at your site or a combination of the two.

Demo

See SAS® Detection and Investigation for Insurance in action.

Detecting and preventing fraud is a global challenge for insurers. Find out how our insurance fraud detection and investigation software uses analytics and machine learning to help you identify claims fraud before claims are paid.

This solution runs on SAS® Viya®, which has the breadth and depth to conquer any analytics challenge, from experimental to mission critical. SAS Viya extends the SAS Platform to enable everyone – data scientists, business analysts, developers and executives alike – to collaborate and realize innovative results faster.